Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Acoustic Neuroma

(Neurilemoma; Vestibular Schwannoma)
Pronounced: Ah-COO-stic New-ROH-mah
by Michelle Badash, MS
Definition

An acoustic neuroma is a low-grade tumor. It is on the eighth cranial nerve leading from the brainstem to the ear. This nerve is involved in hearing and maintaining equilibrium. Acoustic neuromas grow relatively slowly. Even though it is a low-grade tumor, this condition can cause serious problems.

Causes

The exact cause of an acoustic neuroma is unknown.

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition.

Risk factors include:

  • History of the disease neurofibromatosis type 2 (NF2)
  • Age: 30-60 (average age of diagnosis is 50)
  • Family history of NF2
Symptoms

The first symptoms of an acoustic neuroma include:

  • Ringing in the affected ear, called tinnitus
  • Decrease in sound discrimination, especially when talking on the telephone
  • Gradual hearing loss in one ear with near normal hearing in the other ear

As the neuroma gradually enlarges, symptoms may include:

  • Balance problems
  • Facial numbness and tingling
  • Weakness of the facial muscles on the side of the tumor

If headaches or mental confusion occurs, the tumor may be life-threatening. Call your doctor right away.

Diagnosis

The doctor will ask about your symptoms and medical history, and examine your ears and nervous system. Tests may include:

  • Auditory brainstem response test—a test that measures the rate of electric impulses traveling from the inner ear to the brainstem
    • A slowed or absent impulse may indicate the presence of an acoustic neuroma. This test is almost always abnormal in the presence of an acoustic neuroma.
  • Audiogram—a test that measures hearing in both ears
  • CT scan—a type of x-ray that uses a computer to make pictures of the inside of the head
  • Electronystagmography—Cold and warm water or air is inserted in the ear canal, and the resulting dizziness and rapid eye movement are recorded.
  • MRI scan—a test that uses magnetic waves to make pictures of the inside of the head
Treatment

Treatment depends on your age, general health, the size and location of the tumor, and its rate of growth. Treatment may include:

Observation

If the tumor is very small, your doctor may just monitor its growth. This is common among people over age 70.

Microsurgical Removal

As the tumor grows and/or hearing becomes impaired, removal of the tumor may be necessary. The surgical approach depends on the size and location of the tumor. Complications of surgery may include permanent hearing loss and/or paralysis of facial muscles on the affected side.Your doctor will use the auditory brainstem response test to monitor your hearing during surgery.

Radiation Therapy

Radiation therapy is the use of radiation to kill cells and shrink tumors. Radiation is expected to prevent further growth of the tumor. Radiation may be used when tumors are small and surgery is not possible. This method may preserve hearing. It may be giving in several treatments or one large dose.

Prevention

There are no guidelines for preventing acoustic neuroma because the cause is not usually known.

Last reviewed: September 2010 by Rimas Lukas, MD.

RESOURCES:
CANADIAN RESOURCES:
References: